The objective of this Phase I research is to develop a multilingual voice messaging system by which healthcare providers can create and send telephone messages to patients with limited English proficiency (LEP) and low functional health literacy (FHL). The system will offer a large repository of generic voice messages and customizable message templates, all of which are constructed to be culturally sensitive, linguistically accurate, and appropriate to the literacy levels of the intended recipients. By creating an interactive communication channel between patients and providers, the system will fill a void in effective outreach solutions for LEP populations and address the deficiencies inherent in using printed brochures as the dominant means of disseminating health information. During Phase II, the research team will collaborate with a leading New York-based medical institution on two immigrant health initiatives-a cardiovascular health project targeted at South Asian populations during year 1, and a tuberculosis screening program involving Spanish-speaking populations in year 2. Quantitative patient outcomes and qualitative feedback from both providers and patients will be measured according to pre-determined benchmarks. [unreadable] [unreadable] [unreadable]